Regulatory Field Jobs in Troy

Description The Director, Business Intelligence solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Director, Business Intelligence requires an in-depth understanding ..

Job Information Humana Medicaid Associate Director, Compliance Nursing in Troy Michigan Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..

Description The Associate Director, Credentialing/Compliance manages the Dental Credentialing and Compliance team ensuring that dental providers are Credentialed/Re-credentialed according to CMS and State guidelines and that Humana's Dental Networks operate in ..

Job Information Humana AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership in Troy Michigan Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking an AVP to lead ..

Description The Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Supervisor, Compliance ..

Description Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. At Humana, we want to help people everywhere, ..

Description The Lead, Technology and Cybersecurity Exams, Audits, and Client Inquiries is responsible for management of formal and informal technology reviews across IT. This involves a rigorous process which shapes and ..

Description The Compliance Professional 2 ensures compliance with governmental requirements. The Compliance Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. ..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

Description Humana's Associate Vice President (AVP), Technology and Cybersecurity Risk works closely with all areas of Enterprise Information Protection (EIP), Internal Audit, Enterprise Risk Management, business units, regulatory agencies, and industry ..

Job Information Humana Compensation Lead - Career Framework, Market Analysis, Regulatory in Troy Michigan Description The Compensation Lead develops, implements, and administers compensation programs. The Compensation Lead works on problems of ..

Description The Supply Chain Professional 2 reports through Humana's Pharmacy Supply Chain and performs DSCSA (Drug Supply Chain Security Act) compliance related tasks in support of Humana's Pharmacy inventory receiving operations. ..

Description The Associate Director or Cloud Platforms leads the planning, design, and engineering of Humana's AWS and GCP environments. The ideal candidate will have a strong technical background in cloud architecture ..

Description The Lead, IT Compliance assesses the most complex new and existing information systems applications to ensure that appropriate controls exist, that processing is efficient and accurate, and that information systems ..

Job Information Humana Director, Care Delivery and EMR/EHR Technology in Troy Michigan Description The Director, Technology Solutions devises an effective strategy for executing and delivering on IT business initiatives specific to ..

Description The Manager, Compliance - Medicaid State Reporting ensures compliance with governmental requirements. The Manager, Compliance - Medicaid State Reporting works within specific guidelines and procedures; applies advanced technical knowledge to ..

Job Information Humana AVP, Stars and Risk Adjustment National Medical Director in Troy Michigan Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking a talented Physician executive that can ..

Description The Director, IT Compliance audits the most complex new and existing information systems applications to ensure that appropriate controls exist, that processing is efficient and accurate, and that information systems ..

Job Information Humana Compliance (UM) Coordinator 2 in Troy Michigan Description The Compliance (UM) Coordinator 2 conducts and summarizes compliance audits. The Compliance (UM) Coordinator 2 performs varied activities and moderately ..

Description This role will lead a cross-functional technology product team focused on building a world-class developer experience for Humana's external virtual care partners. Integrations in healthcare are often labor-intensive, bespoke, and ..

Description Responsibilities The Insurance Product Manager 2 will: Research each State's Medicaid rules, as it pertains to base benefits, expanded benefits, competitive analysis, etc. for intelligence gathering and strategy formulation Responsible ..

Job Information Humana Manager, Compliance - Agent Investigation Unit in Troy Michigan Description The Manager, Compliance ensures compliance with governmental requirements. The Manager, Compliance works within specific guidelines and procedures; applies ..

Description Humana is seeking a skilled Senior Network Engineer who is a real self-starter and ready to make a positive impact! This person will be directly responsible for leading work on ..